引起儿童急性下呼吸道感染的常见病毒分析

Profile of viral pathogens associated with acute lower respiratory tract infections among hospitalized children

目的分析江西地区引起儿童急性下呼吸道感染的病毒谱特点,为临床合理用药提供参考。方法收集2011年9月-2012年8月江西省儿童医院2276例患有急性下呼吸道感染住院患儿的鼻咽分泌物标本,采用直接荧光法检测流感病毒A、B型(IVA、IVB)、副流感病毒Ⅰ、Ⅱ、Ⅲ型(PIVⅠ、PIVⅡ、PIVⅢ)、呼吸道合胞病毒(RSV)和腺病毒(ADV)7种呼吸道病毒抗原。结果 2276例鼻咽分泌物标本中,共957例标本至少1种病毒阳性,总检出率为41.9%;7种病毒检出率构成比从高到低依次为:RSV 69.7%、PIVⅢ14.1%、ADV 8.7%、IVA2.6%、PIVⅠ2.4%、IVB 2.0%及PIVⅡ0.5%;RSV为秋、冬、春季导致儿童急性下呼吸道感染的主要病毒,3个季节的检出率分别为59.5%、45.4%和38.2%,PIVⅢ在夏季的检出率达高峰,为13.2%;婴儿组、幼儿组、学龄前组和学龄组病毒的检出率分别为43.9%、28.6%、14.3%和5.6%。结论江西地区引起儿童急性下呼吸道感染的主要病毒为RSV,其次为PIVⅢ和ADV,病毒感染具有明显的季节性且随儿童年龄的增长而降低。

OBJECTIVE To investigate the profile of viral pathogens associated with acute lower respiratory tract infection among hospitalized children in Jiangxi area so as to provide reference for rational use of antibiotics. METHODS The nasopharyngeal secretion samples were collected from 2276 hospitalized children with acute respiratory infections （ALRI） in Jiangxi Provincial Children Hospital from Sep 2011 to Aug 2011. Seven common respiratory viruses, including influenza virus A and B （IFu A and IFu B）, parainfluenza virus Ⅰ , Ⅱ , Ⅲ （ PIV I , PIV Ⅱ , PIV Ⅲ ）, respiratory syncytial virus （RSV） and adenovirus （ADV） were detected by direct immunofluo- rescence. RESULTS Totally 957 （49. 5%） of 2276 samples were positive for at least one of tested respiratory viruses, the proportion were as follows.. RSV 69.7%, PIV Ⅲ 14.1%, ADV 8.7%, IVA 2.6%, PIV I 2.4%, IVB 2.0% and PIV I1 0.5%. RSV was the major viral pathogen associated with ALRI hospitalized children in autumn, winter and spring, the detection of RSV was 59.5% in autumn, 45.4% in winter, and 38.2% in spring. The positive rate of PIV Ⅲ in summer was the highest （13.2%）, the positive rates of tested viruses among the in- fants group, toddlers group, preschool group and school age group were 43.9%, 28.6%/%, 14.3%, and 5.6%, re- spectively. CONCLUSION RSV is the predominant viral pathogen associated with ALRI in the hospitalized children in Jiangxin, followed by PIV Ill and ADV. The prevalence of these viruses exhibits the season-dependence and age-dependence.